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Anti-Inflammatory Drugs And Muscle Recovery


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#1 Subdeacon

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Posted 02 November 2011 - 01:52 PM

I've heard tell that NSAIDs (Non-Steroidal Anti-Inflammatory Drugs; aspirin, ibuprofen, etc) can interfere with the body's normal muscle repair and rebuilding processes, those same processes that we as weightlifters are deliberately stimulating to increase our size, strength, physique, etc. (For example, consider this from an article on bodybuilding.com: "Long-term usage of NSAIDs (more than 1-2 days) is widely believed to be counterproductive for muscle recovery, as inflammation is an integral part of the recovery process.")

To what extent do folks here use NSAIDs, and under what circumstances? General soreness? Muscle injury? Other, non-weightlifting injuries and illnesses (e.g., a sprained ankle or a headache)?

(Note: edited to remove inclusion of acetaminophen, which is not an NSAID. My bad.)

Edited by Subdeacon, 02 November 2011 - 02:41 PM.

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#2 FerrousMaverick

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Posted 02 November 2011 - 02:06 PM

In the case of tendinitis, it's a must, along with ice. Just don't overdo it. Basically my protocol has been:
  • Every 4 hours, one dose of NSAID for first two days
  • Every 4 hours, 5-10 minutes icing of the affected area
  • Some non-stressful movement to get blood flowing.
So after today I'll stop the NSAIDs, but keep the icing. So far it's really helped reduce the pain in my elbows.
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#3 Subdeacon

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Posted 02 November 2011 - 02:40 PM

Important detail: acetaminophen is NOT an NSAID:

Unlike aspirin and non-steroidal anti-inflammatory drugs, acetaminophen does not have an anti-inflammatory effect. Instead, it relieves pain by working centrally (in the brain) to switch off the perception of pain. Up to 1,000 mg of acetaminophen may be taken every four hours, up to a total of 4,000 mg within 24 hours.

(from here)

So, as long as you take into account its risks to the liver, acetaminophen shouldn't have any negative effects on muscle recovery?
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#4 5inthehall

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Posted 02 November 2011 - 02:45 PM

Hmmm. I've been taking a long-term course of Diclofenac (prescription NSAID) for a separated shoulder. The doc recommended 3 months of it, and I'm about halfway through. I'm not sure it's helping anything, and I may quit it early.
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#5 Growler

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Posted 02 November 2011 - 03:19 PM

For the cases where longer term, prescription strength doses of ibuprofen (or other NSAID) are recommended by your Dr for some condition where inflammation is counterproductive to the overall healing of some injury...I think the concern for muscle building is somewhat mute.

I had to go on big doses to keep pain in control, and from what I understand help the actual healing, of herniated disc for some months a couple of years ago. In the end I actually gained weight (including fat) because I kept a large diet filled with protein during the layoff. After a small recovery / break in period I didn't notice any real strength loss and quickly surpassed my old levels.

Overall, I'd say if you have some compelling reason to take NSAIDS (herniated disc, bad sprain of some joint, etc)...worry about that first because that will drive your overall plans to train and subsequent growth.

If you're taking a small amount of NSAIDS for some small injury for a short period of time...the overall effect on your training would be small and short lived if there is one. So, I don't really see a concern there.

I think a bigger issue with NSAIDS is real, shown risks of developing GI problems with longer term use. That's why you don't want to be on them for high levels for long periods of time unless you just have to for some reason warranting the risk. I wouldn't sweat taking some advil every blue moon because you have a headache or stubbed your toe. It won't be the reason you stall on a lift, you're diet, rest, and sleep are way more likely to cause trouble IMO.
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#6 littlesimongeorge

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Posted 02 November 2011 - 03:26 PM

Interesting, I've never used NSAIDs for muscle or joint pains.

A lot of people rate Mega Cissus quite highly for joint and muscle pain.
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#7 Mike

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Posted 02 November 2011 - 03:27 PM

I take Advil (ibuprofen) whenever I feel a muscle strain in my back (usually, but not always lifting related). If it's a bad injury I will take them over 3-4 days and take it throughout the day. For a mild strain 1-2 days but only before i go to bed, and when I wake up.

I'm lucky enough to hardly ever get headaches. But for the one or two a year I do get, I'll take an advil.

I've never had any negative issues in regards to lifting due to taking advil. But then again I haven't been forced to take a lot of, so it's unlikely that it would have much of a direct result on anyone's lifting.
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#8 spector

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Posted 02 November 2011 - 10:52 PM

I would say that if you're taking NSAIDs so often that you even have to ask the question, muscle-building shouldn't really be of concern to you; you probably have bigger problems that need to be addressed first.

I never take that stuff because I figure if my body hurts,there is a reason that needs to be addressed. Example: headaches. If I get a headache, it's invariably caused by a tight neck muscle. A few minutes with the theracane and some extra magnesium citrate takes care of most headaches.

I'd also be concerned about working out with pain killers, since you might not get the appropriate pain feedback if something is wrong.

On the other hand, if you KNOW what's wrong and it's just a matter of reducing the pain while you're rehabbing, that's probably valid. But then again, you probably won't be focused on building muscle if you're in that much pain.
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#9 FerrousMaverick

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Posted 02 November 2011 - 11:30 PM

Certain injuries are inflammation based. The most common example is tendinitis, and the NSAID is usually suggested to deal with the inflammation itself rather than the pain. In general, I do agree that regular use of them to deal with pain is not good.
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#10 JohnR

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Posted 03 November 2011 - 06:22 AM

Agree with FeMaverick.

I use diclofenac to reduce inflammation in one shoulder that is brought on by heavy or high-volume bench pressing. Its effectiveness is impressive and I've never had to take more than three 50mg tablets over a period of a couple of days. Usually one tablet is all I need. I'd say I average about 4-5 tablets a month.

So I take anti-inflam, sparingly, in the hope of giving my tendons more chance of surviving in a pretty hostile environment. There's a vicious circle if inflammation goes untreated:
Inflammation --> more pressure between tendon and bone --> more abrading of the tendon --> more inflammation.

Clouding the issue is the fact that anti-inflams are also considered as pain relievers. It would be interesting if you could tell just how much an anti-inflam is masking pain versus how much the pain is reduced because of reduced pressure brought about by the reduction in inflammation. The pain reduction is kind of a nice spin-off, but as has been mentioned, taking medication just to reduce pain is not something you should make a habit of.

Regarding the OP's point about muscle recovery - who knows how much truth there is to it, but I think if it was a common and significant effect it would be well documented. As someone else pointed out - if you're taking that many anti-inflams you've probably got bigger things to be concerned about than muscles being slow to recover.
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#11 FerrousMaverick

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Posted 04 November 2011 - 01:08 PM

Regarding the OP's point about muscle recovery - who knows how much truth there is to it, but I think if it was a common and significant effect it would be well documented. As someone else pointed out - if you're taking that many anti-inflams you've probably got bigger things to be concerned about than muscles being slow to recover.


I wonder if that thought process is from the bodybuilding community. They are concerned with the size of the muscle more than the strength of the muscle. I would think the training is sufficient to cause strength adaptation regardless of NSAID use.
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#12 Subdeacon

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Posted 04 November 2011 - 01:42 PM

I would think the training is sufficient to cause strength adaptation regardless of NSAID use.


That's pretty much what I'm wondering about: does NSAID use have a negative effect on muscle regeneration (either for strength or for hypertrophy), and if so, is it significant? I'm not thinking so much about prescription use, but about someone who takes a couple of aspirin or Advil to help with a particularly nasty case of DOMS, for example. Might such a person be unwittingly reducing their strength and size gains, and if so, by how much? In essence, what is the trade-off between less pain and slower advances in training? If there are negative effects of NSAIDs, can they be avoided by using non-NSAIDs such as acetaminophen?

I've run across a couple of articles that present some interesting info. In one study, use of both acetaminophen and ibuprofen had a negative effect in the short-term, but another study by the same researches showed a positive effect in the long term. The problem is that the two groups weren't the same age, so it's hard to draw real comparisons between the two. As one article noted:

An elderly muscle may respond very differently than a young muscle. We can't assume that the [positive] results will apply to younger people in their twenties, thirties and forties.

Finally, some elderly people may suffer from age-related aches and pains. The pain killers may have allowed them to train harder during each workout, which could have contributed to the extra gains in muscle size and strength.


This article presents the following "Bottom Line":

The extent to which the prolonged use of pain killers affects muscle growth over a period of several weeks or months is open to debate. However, there is mounting evidence that high doses may extinguish the fire that sparks muscle growth after exercise.

While the occasional use of pain killers in moderate amounts isn't likely to suppress your gains completely, they're certainly not something you should use too often. Large doses taken on a regular basis could easily add up to a negative impact on muscle growth in the long run.


The full article is at http://www.thefactsa...painkillers.htm; I'd be interested in what the other folks here think of it.
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#13 AkumaZ

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Posted 06 March 2012 - 07:48 PM

Not sure about its effects on muscle recovery, but i figured this is worth sharing

Whenever i go on ibuprofen it's usually pretty short term (2 weeks max) but high doses. According to a dentist i've met anything less than 2400mg/day (3 doses of 800mg) is pretty much analgesic and wont do very much in terms of actually helping the inflammation.

Rippetoe's ibupfrofen protocol is 3200mg/day for 5 days and then off completely (probably for a couple months)
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#14 Growler

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Posted 06 March 2012 - 07:57 PM

2400 per day was all they (dr's) wanted me taking for herniated disc pain. if you felt the need to exceed that i'd consult a medical dr, as there might be something more appropriate for you to be taking/doing.

but yeah, if you an abscesed tooth or sciatica, 1200 of ibuprofen isn't going to help.
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#15 DonkeyKong

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Posted 09 March 2012 - 04:34 AM

I'll chuck some anecdotal evidence into the mix. I used to train Olympic lifts under the coaching of a guy (Giles) that won a gold medal at the Commonwealth games for England in the snatch. He was as big as an Ox and twice as strong. He used to train 9x + per week, and would regularly get pain that was controlled by ibuprofen. He told me that in the run up to the Commonwealth games he was prescribed 5g of the stuff per day by the team doctor, which was so much he started shitting blood. He lowered the dose after that.

But the point is - he was as big as an Ox and twice as strong, whilst taking an absolute shit ton of ibuprofen (and who knows what else). I doubt one or two tabs for the odd ache/pain is going to make a damn bit of difference to a recreational lifter. 10 minutes more sleep that day would probably have more impact.
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#16 Maslow

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Posted 15 May 2012 - 02:23 PM

At the 70s Big seminar I attended Justin Lascek responded to this question by pointing out that Iburprophen irritates the stomach and can cause so much inflammation in the guts that the body has to use more energy attending to the gut than healing the original problem. So as others have said, it may be something to do from time to time for acute pain, but not something to do on a regular basis for general DOMS.

I once took about 1600 mg of iburpohen daily for two weeks when I had some bad sciatic pain flaring up. I stopped at about the two week mark because I started seeing blood on my toilet paper. Never again lol.
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